Attachment V - Past Performance Survey (Fillable).doc
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- Solicitation number
- 1131PL23RDM31101
About this file
This document contains a federal solicitation for an energy sector definitional mission to South Asia, Southeast Asia, and the Pacific Islands. The solicitation was issued by the United States Trade and Development Agency under number 1131PL23RDM31101. Offerors must register in the System for Award Management to be eligible for award. Proposals are due by April 27, 2023 at 1:00 PM Eastern Time and the award will be a single contract to the offeror deemed to represent the best value. The undefinitized contract will be for professional services related to conducting an energy sector definitional mission to the specified regions. Contractor and subcontractor employees must be U.S. citizens or lawful permanent residents. Subcontractors may comprise no more than 50% of the proposed price.
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Text version
Solicitation Regional South and Southeast Asia and the Pacific Islands: Definitional Mission Energy Opportunities. Solicitation No.: 1131PL23RDM31101
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, April 27, 2023, Arlington, VA Time.
Name of Contractor Being Reviewed:
Contract Number/Reference Information:
Name of Agency/Organization Submitting Review for this Contractor:
| Name of Person Completing Questionnaire |
| Phone Number |
| Email Address |
| Period of Performance: XX/XX/XXXX – XX/XX/XXXX |
| Brief Description of Services: XXXXXXXXX |
Total Contract Value: $XXXX.XX
Contract Performance Information
| Questions: |
| Response: |
| 1. How would you rate your confidence in the contractor’s ability to comply with contract terms and conditions? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 2. How would you rate your confidence in the contractor’s ability to complete work on schedule? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 3. How would you rate your confidence in the contractor’s ability to comply with the actual requirements? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 4. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
5. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.
· Yes
· No
Comment:
| 6. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss? |
| · Yes |
· No Comment:
USTDA sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.
Additional Comments:
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